How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $181.97 Median $478.63 Typical High $7,244.36 | Facility | None | $181.97 | $478.63 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $331.13 | Professional | None | $181.97 | $251.19 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $602.56 Typical High $1,288.25 | Facility | None | $416.87 | $602.56 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $389.05 | Professional | None | $181.97 | $269.15 | $389.05 |
Highmark BCBS Setting Facility Modifier None Typical Low $389.05 Median $933.25 Typical High $7,585.78 | Facility | None | $389.05 | $933.25 | $7,585.78 |
Highmark BCBS Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
United Setting Facility Modifier None Typical Low $229.09 Median $398.11 Typical High $1,698.24 | Facility | None | $229.09 | $398.11 | $1,698.24 |
United Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $398.11 | Professional | None | $169.82 | $251.19 | $398.11 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $107.15 Typical High $141.25 | Professional | 52 · Reduced service | $91.20 | $107.15 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $42.66 Typical High $57.54 | Professional | 53 · Discontinued | $37.15 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $162.18 Typical High $213.80 | Professional | 54 · Surgery only | $138.04 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $32.36 Typical High $42.66 | Professional | 55 · Aftercare only | $27.54 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $21.38 Typical High $28.18 | Professional | 56 · Pre-op care only | $18.20 | $21.38 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $151.36 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $128.82 | $151.36 | $199.53 |
Where Delaware sits
The same service costs 3.6 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Delaware· 46th of 51
$269
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.